Could she have been right when she said that he was the candidate of lofty promises —“the skies will open, the light will come down, celestial choirs will be singing and everyone will know we should do the right thing and the world will be perfect” — and not the candidate of real leadership?

In her former life as a presidential candidate, Clinton warned voters that Obama would let them down. She warned them that when the going got tough, he would fold up.

She said it was not just a matter of Obama lacking experience — that was the least of it — but that he lacked the strength, the toughness, the will to get the job done.

Michelle Obama: First Lady in Action

In January 2008, at Nashua High School North just before the New Hampshire primary, Clinton said of Obama: “I applaud his incredible ability to make a speech that really leaves people inspired. My point is that when the cameras disappear and you’re there in the Oval Office having to make tough decisions, I believe I am better prepared and ready to lead our country.”

Democratic voters disagreed with her (though she did win New Hampshire), and Obama went on to win both his party’s nomination and the presidency. But Clinton, now his secretary of state, left him with a warning: “You campaign in poetry, but you govern in prose.”

It is prose time for Obama.

Obama the Family Man

And we are now going to see how he governs when it comes to meaningful health care reform. In his heart and in his head he knows what it takes for such reform. He knows that a public option — a government-run health care program like Medicare — has the best chance of competing with the insurance industry.

In Grand Junction, Colo., last week Obama said that if the public option “could keep its costs lower and provide a good-quality service and good benefits, then that would help keep the insurance companies honest.”

The public option would do so by creating not socialism but competition. In order to compete with the huge health care industry, you have to be huge yourself or you get steamrollered. That’s why a public option would work and a system of smaller health care “co-ops” almost certainly would not.

Obama Family Vacations in Photos: Martha's Vineyard

In general, the health care industry wants health care reform and for a very simple reason: It would mean 47 million new customers, many of them young and healthy.

But the industry does not want a public option as a part of that reform, because a public option would be large enough to negotiate with private insurers, pharmaceutical companies, hospitals and doctors for lower costs.

“A public option would cut deeply into their current profits,” writes Robert Reich, former secretary of labor under Bill Clinton. “That’s why they’ve been willing to spend a fortune on lobbyists, threaten and intimidate legislators and ordinary Americans, and even rattle Obama’s cage to the point where the administration is about to give up on it.”

We don’t know for sure that Obama is about to give up on the public option. I think, in the end, he will not. I think he may be tougher than some think and stronger than the polls show. But I admit there are troubling signs.

“The public option, whether we have it or we don’t have it, is not the entirety of health care reform,” Obama said at Grand Junction. “This is just one sliver of it, one aspect of it.”

But it is a very important sliver, a critical aspect. And how Obama acts right now on health care reform could tell us how he will act for the rest of his presidency.

Sometimes it is not enough to have just your heart and your head in the right place. You have to have your guts there, too.